Question

You are working in the E.D. when Art, age 74 , comes in accompanied by his wife. This afternoon he began vomiting and "filled the toilet" with red blood. He has also noticed black stools for the last 2 days. Assessment data: BP 82/60, HR 120, RR 28, skin cool, Hgb 5, Hct 16.

What type of shock do you suspect?

Answer 1

Art is experiencing hypovolemic shock due to significant loss of blood volume, as evidenced by vomiting of blood, black stools, low blood pressure, high heart rate, and low hemoglobin levels.

Step-by-step explanation:

The patient, Art, exhibiting symptoms such as vomiting of red blood, black stools, low blood pressure (BP 82/60), high heart rate (HR 120), rapid respiratory rate (RR 28), cool skin, and significantly low hemoglobin (Hgb 5) and hematocrit (Hct 16) levels, is likely experiencing hypovolemic shock. This type of circulatory shock is typically caused by a significant loss of blood volume, which can be from internal or external hemorrhage. Art’s symptoms of vomiting red blood and presenting black stools (indicative of digested blood, likely from an upper gastrointestinal bleed) support this diagnosis. The body responds with tachycardia (increased heart rate), hypotension (low blood pressure), and other signs of shock as it attempts to maintain adequate circulation to essential organs despite the loss of blood volume. Treatment focuses on stopping the source of the bleeding and restoring the blood volume with intravenous fluids and possibly blood transfusions.